Does B-type Natriuretic Peptide Level Predict Outcome After Arterial Switch Operation?

Ziya Totonchi¹, Masoud Ghorbanlou², Mehrdad Mesbah Kiaei², Ahmad Yousefzadeh³ and Mahmoud Reza Mohaghegh^4*

¹Cardiac Anesthesiologist , Rajaie Cardiovascular Medical and Research Center , Iran University of Medical Sciences , Tehran , Iran ²Cardiac Anesthesiologist , Hasheminejad Kidey Center ,School of Medicine , Iran University of Medical Sciences , Tehran , Iran ³Cardiac Anesthesiologist , Lorestan University of Medical Science , Khorramabad, Iran ⁴Anesthesia and Critical Care Department , Hasheminejad  Kidey Center ,School of Medicine , Iran University of Medical Sciences , Tehran , Iran.   Corresponding Author Email: mohaghegh_mr@yahoo.com

DOI : http://dx.doi.org/10.13005/bbra/2045

ABSTRACT: evaluation the predictive value of perioperative Plasma B-type natriuretic peptide level in arterial switch operation. Plasma B-type natriuretic peptide level was measured before and  and 24 hours after surgery in 29 patients with arterial switch operation. we evaluated 29 patients (22 male,76%,7 female 24%) with mean age 67.93±84.09 days (range 6 days to 14months).The mean of BNP level before surgery was 7989.96±9691.94 and increased after surgery to 22391.35±11898.67 and difference between two groups was significant (P=0.003).In linear regression test the BNP did not correlate with sex(r=0.33, P=0.085) and age(r=0.14,P=0.45). Furthermore, BNP did not correlate with duration of mechanical ventilation (r=0.132,P=0.53) , ICU stay (r=0.137,P=0.52) and with lactate level (r=0.41,P=0.054)after operation. During the study 4 patients(13.8%) died and the mean of BNP 24h after operation among them was 35000.00±00.00.using chai-square and fisher exact test the correlation between BNP  and death was significant(P=0.001). we implied that BNP  level increased 24 hours after arterial switch operation, moreover we denoted it correlated well with the death rate and an increase in B-type natriuretic peptide 24 hours after surgery predicts poor postoperative outcome. However it did not correlate with duration of mechanical ventilation ,ICU stay and lactate level in this patients.

KEYWORDS: BNP; arterial switch operation; duration of mechanical ventilation

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